Getting our money's worth out of a high-quality, low-cost health care system

Excerpt

Experts and the American public agree that our health system is ailing:

• Costs are too high and still growing rapidly.

• Millions of people lack access to care.

• The United States lags behind many other developed nations on several measures of quality.

• The costs of publicly funded health programs put immense pressure on federal and state budgets.

In fact, the single greatest challenge to federal budgets in the future is not defense spending, Social Security deficits or pork-barrel projects. It is the rapid rise in health care costs. Unless that is addressed, we will face the prospect of large tax increases or an even higher national debt.

As health care debates have dominated the agenda in Washington, a group of Iowa experts has also been contemplating much-needed reform over the past several months. This group, the Iowa Committee for Value in Healthcare, has determined that reform efforts must focus on achieving greater value in our health care system.

The committee responded to evidence showing that the U.S. spends substantially more per person on health care than other countries do. Yet we do not always get better results for our higher spending. Even within this country, some regions have higher spending than others without significant differences in outcomes.

To help inform the national discussion, the committee picked five key principles for spending health care dollars more wisely. These principles are based on Iowa's record of high-value care.

The Iowa committee is part of the Fiscal Stewardship Project hosted by The Concord Coalition, a non-partisan grassroots organization dedicated to fiscal and generational responsibility. The Concord Coalition believes that citizens and community leaders -- when presented with the facts and given a chance to work through a wide range of fiscal policy options and trade-offs -- are willing to contribute realistic solutions to the nation's challenges.

The Iowa committee conducted its business under a two-fold premise:

• The continued rise in costs makes our current health system unsustainable, and

• This group could make a unique and significant contribution to the national debate by drawing on the experience of committee members working in a high-value system.

The committee strongly believes that national reform can, and must, lead to a system that produces higher-value care while increasing access to that care. Is all the rhetoric on Capitol Hill in line with the committee's principles? Not completely. More needs to be done to ensure that reform is fiscally responsible -- not just over the next 10 years but far into the future.

However, aspects of both the House and Senate versions of reform are aligned with the Iowa committee's principles. There is emphasis on primary care and supporting the accountable care and medical home models. Chronic care management, and prevention and wellness to minimize disease, are also supported.

Congress and the president should add more improvements that can help transform the system within a fiscally responsible framework.

The committee's final report outlines evidence and numerous examples of Iowa practices that support the five principles. This report will be released at 9 a.m. Monday at the Embassy Suites in Des Moines. The public and media are invited to attend the conference, where they can learn more about this report and participate in a conversation with Iowa committee members.

The discussion will be lead by Michael Millenson, a nationally recognized health quality expert and author. For more information and to register for this free event, see the calendar page at www.public-health.uiowa.edu.